{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,6]],"date-time":"2026-06-06T15:41:55Z","timestamp":1780760515818,"version":"3.54.1"},"reference-count":30,"publisher":"The Korean Society of Gastrointestinal Endoscopy","issue":"4","license":[{"start":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T00:00:00Z","timestamp":1740355200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/3.0\/"}],"content-domain":{"domain":["e-ce.org"],"crossmark-restriction":true},"short-container-title":["Clin Endosc"],"published-print":{"date-parts":[[2025,7,30]]},"abstract":"<jats:p>Background\/Aims: Malignant biliary obstruction is a major clinical challenge. We assessed the efficacy of endoscopic ultrasound-guided biliary drainage (EUS-BD) compared with that of endoscopic retrograde cholangiopancreatography biliary drainage (ERCP-BD) or percutaneous transhepatic biliary drainage (PTBD).Methods: We searched for randomized controlled trials comparing EUS-BD with ERCP or PTBD in treating malignant biliary obstruction. Using random-effects models, we synthesized risk ratios (RRs) and weighted mean differences (WMDs) with 95% confidence intervals (CIs). A subgroup analysis was performed using a comparator (ERCP or PTBD).Results: EUS-BD significantly reduced the risk of stent dysfunction (RR, 0.46; 95% CI, 0.33\u20130.64), with consistent results in subgroup analysis for ERCP (RR, 0.54; 95% CI, 0.35\u20130.84) and PTBD (RR, 0.37; 95% CI, 0.22\u20130.61). It also lowered the risk of post-procedure pancreatitis (RR, 0.24; 95% CI, 0.07\u20130.83) and reduced tumor ingrowth or overgrowth risk (RR, 0.27; 95% CI, 0.11\u20130.65), even when compared to ERCP alone (RR, 0.28; 95% CI, 0.11\u20130.70). EUS-BD demonstrated a lower risk of adverse events compared to PTBD (RR, 0.37; 95% CI, 0.14\u20130.97) and reduced length of hospital stay (WMD, \u20131.03; 95% CI, \u20131.53 to \u20130.53) when compared to ERCP.Conclusions: EUS-BD outperformed ERCP-BD and PTBD in reducing stent dysfunction, postprocedural pancreatitis, and tumor ingrowth or overgrowth.<\/jats:p>","DOI":"10.5946\/ce.2024.183","type":"journal-article","created":{"date-parts":[[2025,2,24]],"date-time":"2025-02-24T02:16:19Z","timestamp":1740363379000},"page":"533-543","update-policy":"https:\/\/doi.org\/10.5946\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Efficacy of endoscopic ultrasound-guided biliary drainage of malignant biliary obstruction: a systematic review and meta-analysis of randomized controlled 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